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Updated: Sep 5, 2025

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Impact of postoperative patient-prosthesis mismatch as a risk factor for early structural valve deterioration after
Tatsuto Wakami1, Shigeki Koizumi1, Tadaaki Koyama2
1Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi Chuoku Kobeshi Hyogoken, Kobe, 650-047, Japan.
Background:
Several studies have reported high rates of structural valve deterioration (SVD) in the Trifecta valves. Herein, we analyzed the midterm results of the Trifecta valve and risk factors for early SVD.
Methods:
We retrospectively reviewed the records of 110 patients who had undergone Trifecta implantation between January 2012 and December 2017.
Results:
We encountered seven cases of Trifecta valve failure. We performed a redo aortic valve replacement in five patients and a transcatheter aortic valve replacement in two patients. The SVD rate was 4.8% at 5 years and 6.6% at 7 years. The mean pressure gradient and peak velocity on the first postoperative echocardiogram in patients with SVD were higher than those in patients without SVD. The SVD rates with and without patient-prosthesis mismatch (PPM) were 2.8% and 12.6% at 5 years and 2.8% and 20.0% at 7 years. PPM is a risk factor for SVD. Noncoronary cusp tears were observed in all patients who had undergone redo surgery.
Conclusions:
The most common cause of SVD was noncoronary cusp tear. Patients with PPM are at high risk of developing SVD.
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